目的 探讨鼻咽癌颈部淋巴结转 移的CT表现及放疗后局部复发的CT特点研 究。方法 纳入我院2000年1月-2015年1月 进行CT检查并经过病理检查确诊为鼻咽癌 患者200例。分析患者颈部淋巴结转移的 CT图像，并与病理结果进行对比。另择取 放疗复发的患者100例，分析患者的CT图 像，并进行总结。结果 经病理检查确诊 为鼻咽癌的200例患者中，经CT检查发现 发生颈部淋巴结转移患者有176例(88%)。 其中咽后组、颈上深组、颈后三角区、颈 中深组、颈下深组、锁骨上区淋巴转移率 分别为59.7%、74.4%、25.6%、62.9%、 49.3%、27.6%。而颌下淋巴结、颏下淋巴 结以及腮腺内淋巴结转移率分别为7.3%、 1.7%以及2.8%。162例患者增强扫描发 现，淋巴结轻、中度强化患者95.51%，无 强化患者1.28%，明显强化患者0.64%。在 转移的淋巴结中密度均匀及不均匀的分别 为50.6%、35.8%。6.8%出现大片坏死区， 7.4%出现环状低密度区。鼻咽癌复发部位 多为鼻咽部，本次观察94例均为鼻咽部复 发，5例患者为单纯颅底复发，另1例为单 纯颈部淋巴结复发；48例出现颈部淋巴结 复发，其中双侧颈部淋巴结复发20例，其 余均为单侧复发。结论 鼻咽癌患者中淋 巴结转移较为常见，多为咽后及颈静脉淋 巴，其CT下典型表现为密度均匀，较为规 则。

Objective To study the CT performance for cervical lymph node metastasis and CT features of local recurrence after radiotherapy in NPC. Methods From January 2000 to January 2015, 200 NPC patients received CT scanning and were clinically confirmed in our hospital. CT imaging about cervical lymph node metastasis was analyzed and the pathological results were compared. CT imaging about 100 recurrent cases after radiotherapy was concluded. Results Through CT examination, the incidence rate of cervical lymph node metastasis was 88% (176/200); the rates of metastasis in retropharyngeal, superior deep cervical area, posterior triangle and neck, middle deep cervical area, interior deep cervical area and supraclavicular area were 59.7%, 74.4%, 25.6%, 62.9%, 49.3% and 27.6%; the rates of metastasis in submandibular lymphatic node, submental node and intraglandular parotid node were 7.3%, 1.7% and 2.8%. Based on CT enhancement scanning, 95.51% of lymph nodes were slightly and moderately enhanced with 1.28% of non-enhancement cases and 0.64% of significant enhancement cases. 50.6% of lymph nodes were evenly distributed; 35.8% of nodes were not evenly distributed. 6.8% of lymph nodes contained large areas of necrosis; 7.4% of nodes contained cyclic low-density areas. NPC majorly re-appeared in nasopharyngeal region. There were 94 recurrent cases in nasopharyngeal region, 5 cases in skull base, and 1 case of cervical lymph node; there were 48 cases of cervical lymph nodes with 20 cases in bilateral sides and the other cases in unilateral side. Conclusion For NPC patients, it is easy to appear the cervical lymph node metastasis, especially in retropharyngeal area and jugular vein. CT is typically appeared with a uniform density and in a regular way.